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LAIS

Loberamisal for Acute Ischemic Stroke

Year of Publication: 2026

Authors: Shuya Li et al.

Journal: Presented at American Stroke Association International Stroke Conference 2026

Citation: Late-Breaking Science Presentation, ISC 2026, New Orleans

Link: https://doi.org/10.1136/svn-2025-004582


Clinical Question

Does loberamisal, a dual-acting neuroprotective agent, improve functional recovery when administered within 48 hours of moderate to severe acute ischemic stroke?

Bottom Line

Loberamisal significantly improved excellent functional recovery at 90 days (69% vs 56%) with a favorable safety profile, representing the first successful Phase III neuroprotective agent trial in acute ischemic stroke

Major Points

  • First successful Phase III trial of a neuroprotective agent for acute ischemic stroke
  • 998 patients with moderate to severe stroke (NIHSS 7-20) across 32 centers in China
  • 13% absolute increase in excellent functional recovery (mRS 0-1) at 90 days
  • Dual-target mechanism designed to preserve neurovascular unit function
  • Treatment initiated within 48 hours and continued for 10 days
  • Safe profile with no increased serious adverse events or mortality
  • Only 17% received IV thrombolysis, limiting assessment of combined effects

Design

Study Type: Phase III randomized controlled trial

Randomization: 1

Blinding: Double-blind, placebo-controlled with computer-generated randomization; neither investigators nor participants knew treatment assignment

Enrollment Period: July 2024 to April 2025

Follow-up Duration: 90 days

Centers: 32

Countries: China

Sample Size: 998

Analysis: Intention-to-treat analysis including 20 participants who did not complete 90-day follow-up


Inclusion Criteria

  • Adults aged 18-80 years
  • Confirmed acute ischemic stroke (blocked vessel)
  • NIHSS score 7-20 (moderate to severe stroke)
  • Treatment initiated within 48 hours of symptom onset
  • No mechanical thrombectomy performed

Exclusion Criteria

  • History of hemorrhagic stroke
  • Severe consciousness impairment
  • Transient ischemic attacks
  • Blood pressure >220/120 mm Hg despite treatment
  • Severe mental health condition, dementia, depression, or anxiety
  • Severe liver or kidney disease
  • Underwent vascular surgery
  • Malignant tumors with life expectancy <90 days
  • Pregnant or lactating
  • Known allergy to loberamisal
  • Major surgery scheduled within 4 weeks
  • Participation in another clinical trial

Arms

FieldLoberamisal GroupControl
InterventionDaily intravenous infusion of 40 mg loberamisal for 10 consecutive days, started within 48 hours of stroke symptom onsetMatched placebo intravenous infusion daily for 10 consecutive days, started within 48 hours of stroke symptom onset
Duration10 days treatment, 90 days follow-up10 days treatment, 90 days follow-up

Outcomes

OutcomeTypeControlInterventionHR / OR / RRP-value
Excellent functional recovery defined as modified Rankin Scale score 0-1 (little to no disability) at 90 daysPrimary56%69%8
Serious adverse eventsSecondaryNot specifiedNo increased risk vs placebo
Mortality at 90 daysSecondaryNot specifiedNo increased risk vs placebo
Overall safetyAdverseNot specifiedNo increased risk of serious side effects or death compared to placebo

Subgroup Analysis

Only 17% of participants received IV thrombolysis, limiting assessment of combined treatment effects. Patients who received mechanical thrombectomy were excluded


Criticisms

  • Conducted only in China, limiting generalizability to other populations and ethnic groups
  • Only 17% received IV thrombolysis, limiting assessment of combined neuroprotection with reperfusion therapy
  • Most patients had moderate stroke severity (NIHSS 7-20), may not apply to very severe strokes
  • Patients who received mechanical thrombectomy were excluded, limiting real-world applicability
  • No biomarkers (blood or imaging) assessed to understand mechanism of action
  • Short follow-up duration (90 days only)
  • Preliminary results from conference presentation, full publication pending peer review
  • Specific numbers for each treatment arm not reported in press release

Funding

Not specified in press release

Based on: LAIS (Presented at American Stroke Association International Stroke Conference 2026, 2026)

Authors: Shuya Li et al.

Citation: Late-Breaking Science Presentation, ISC 2026, New Orleans

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